Sex for heroin

Addiction leads to desperation

Tonya had battled an addiction to pain pills, but it wasn’t until she used heroin that she first sold her body. She was 46.

The Cincinnati native, who asked to be identified by first name only, had relapsed into prescription pill use after a surgery and was turned on to its cheaper cousin, heroin, by her roommate.

“(Heroin) is a double stroke itself. It will make you do things in your life you never thought you’d do,” she said. “I lost my house, my kids. Living on the streets with no income, (prostitution is) the easiest thing in the world to do.”

After an overdose landed her in Good Samaritan Hospital and she discovered the heroin use was worsening a pair of carotid aneurysms, Tonya sought out Off the Streets. The program, ran by social service agency Cincinnati Union Bethel, aims to help sex workers reclaim their lives.

“I’m so grateful to be here. … I’ll tell anybody that listens to me, there’s a solution today,” Tonya said.

As officials across the country have turned an eye toward targeting sex traffickers over the past three years, the movement has swept up with it all types of prostitution. The result has been a heightened sense of interest in getting sex workers help instead of sending them to jail. Amnesty International, the world’s largest human rights group, recommended in July to decriminalize prostitution.

In Cincinnati, the conversation of helping sex workers began a decade ago.

“(The foundation of Off the Streets) is honor, respect, dignity, hope, and accepting where the women are when they come in the door,” said Mary Carol Melton, who directs the program.

Off the Streets

Cincinnati program offers solution

Bernice Childers, 49, was among the first to turn to Off the Streets when it began in 2006. She was introduced to prostitution more than two decades before by friends who were working in a Kentucky strip club.

“At that time, I was so young (19), I didn’t even know it was prostitution, but I just always knew I had dealt with businessmen and I made easy money,” Childers said.

By 2006, she was not only a survivor of child molestation but also addicted to drugs and alcohol, had been in two abusive marriages, watched her seven children be adopted, and had friends be killed or die from drug overdoses.

“It was real scary. It came to times where I was raped, I was choked, I was beaten, I was left places. There was many times I should have been dead,” Childers said.

“We do not use the word prostitute because women are not what they have done to survive.”

Mary Carol Melton, Off the Streets program director

Cincinnati leadership began to realize they needed to do something new as a study revealed the primary subgroup of women overcrowding jails were those arrested for soliciting and prostitution, Melton said. With the help of grant money, a committee of various agencies and city leadership came together for a year to study the issue and develop ways to address it.

The group discovered that, during the previous two years, not a single woman arrested on prostitution charges had successfully completed probation, Melton said. Interviews with 100 women in the Hamilton County Justice Center revealed a third had both mental health and addiction issues that were not diagnosed or being addressed.

“Our treatment providers ... were reporting that some of these women could teach treatment they had been through treatment so often, but they had never addressed the shame and the trauma of the prostitution.” Melton said.

In the beginning, about 70 percent of the women in Off the Streets were referred by the court, but now, about 70 percent walk in on their own. A key to it has been using peers in recovery to lead the program, Melton said.

While they refer women to whatever services they need, such as counseling or drug treatment, Off the Streets provides programs such as yoga, journaling, creative arts, and nutrition.

“We do not use the word prostitute because women are not what they have done to survive. That does not define them. And what defines them is their whole sum of life experiences,” Melton said.

Between 2006 and 2014, the program served 724 cases, all of which involved women who were homeless and 95 percent of whom abused drugs or alcohol. For women who spent at least a month in the program, 85 percent report that they aren’t using drugs or alcohol, 90 percent are no longer in prostitution, and 74 percent were without a new prostitution conviction within a year of graduating.

Childers graduated from the program and remained in recovery for six years. When she didn’t follow things she had learned, such as maintaining a sponsor, she relapsed and found herself turning back to Off the Streets 10 months ago. She graduates again in September.

“They accept you. They welcome you in. They don’t beat you up and make you feel like you’re nothing. … They build you up,” she said.

New kind of justice

Judges taking alternative approaches

Off the Streets wasn’t the only solution the group came up with. It also has a municipal mental health court and is working on creating another specialized court for those facing prostitution charges.

Other cities are experimenting with the same general idea, but they’re not always helpful, said Katie Hail-Jares, a Sex Workers Outreach Project board member. In New York, a primary issue has been that the treatment isn’t always in-depth, she said.

Jares, who has been researching prostitution and doing outreach in Washington, D.C., for about five years, said that, although research on it is scarce, there are promising reports coming from Project Dawn Court in Philadelphia.

The court, which started as a pilot in 2010 and began in full force in 2013, is designed for chronic offenders, not just first-timers like in the New York courts. The court is modeled after the city’s nationally recognized drug court and provides intensive supervision for a year.

No white knights

Some outreach targets harm reduction

As communities are delving into new approaches, Hail-Jares’ work with the national Sex Workers Outreach Project and HIPS in Washington, D.C., focuses on harm reduction.

She describes prostitution as having two extremes — those who choose it as a career and those who are forced or coerced into it by another. However, the majority of those actively in prostitution fall into a gray area that Hail-Jares refers to as circumstance, which includes addiction, poverty or difficulties getting a job because of a criminal record.

CLOSE

Off the Streets: Peggy

Instead of treating everyone like a victim who needs rescuing, harm reductionists like Hail-Jares spread education on available health, education and recovery services. They also provide tips on increasing safety, such as not working the street alone or arranging encounters online to better control the date, and they aim to protect health by providing condoms, clean needles and the overdose reversal medication Narcan.

“That’s not the happy ending people want, but it does empower people. It lets them know that the community cares about them even when they are using (or prostituting),” Hail-Jares said.

The idea that women can control paid sexual encounters or make prostitution safe is unfathomable to Lisa Thompson, who does outreach and education at the National Center on Sexual Exploitation. The center, based in Washington, D.C., primarily conducts awareness campaigns and events to pressure businesses to end connections to various forms of sexual exploitation, such as pornography, and encourage legislators to enact stricter laws.

“I don’t know why anybody thinks a woman can set the parameters. When you’re alone with a man in a room, can you really set the parameters?” Thompson said.

Although controversial, harm reduction is a method Hail-Jares feels decreases stigma and allows people to feel more comfortable about reaching out for help.

Rural tailoring

Finding a way to emulate big city solutions

Prostitution in cities such as New York, Washington, Philadelphia and Cincinnati has been a commonplace issue to tackle, but it has been bleeding into more rural communities. Police in Chillicothe and Mansfield have noted an increase as a direct result of the opioid epidemic and increased access brought through the Internet.

Though metropolitan areas tend to have more treatment resources and have already embarked on new methods to address prostitution, Melissa Holland, who began a program to help women in Reno, Nevada, said there’s no reason smaller communities can’t emulate big-city programs.

“The smaller the community, the better the odds because people seem to care more and you see results,” said Holland, who spent most of her life in Chillicothe.

Awaken has a similar model to Off the Streets in that it partners with existing resources, such as drug treatment and counseling, and provides women a safe place to live while healing.

Holland, Melton and Hail-Jares all said it takes the community caring to do something to make a real change.

“You can start somewhere and you may not have all the answers and resources in place, but you can do something and you can do something in a way that brings the best thinking from the different vantage points,” Melton said.

Ohio, with the creation of a statewide task force in 2012, already has been devoting resources that could help communities, which includes the creation of regional coalitions covering two-thirds of the state. Last year, the state embarked on an awareness campaign, and nearly 5,000 officers received human trafficking training. Committees continue to work on other aspects, such as developing tools and guidelines to educate youths about human trafficking.

Last year, mental health professionals in Ohio’s prisons began screening women to discover how many have been trafficked, with the goal of providing targeted therapy for them. In 2014, the prison system identified 187 women who reported through the screenings that they had been trafficked at some point, according to the task force’s July report.

Part of the push has been a result of Toledo being recognized as the fourth-largest recruitment site for human trafficking in the nation.

“We’ve really seen a mind shift to start thinking how can we break the cycle. … We’re moving in the right direction,” said Amy O’Grady, the Ohio Attorney General’s Office director of criminal justice initiatives.

Brighter days

Setting goals and making plans

Childers and Tonya both feel they’re heading in the right direction and have set out goals for their lives upon graduation from Off the Streets.

Childers already has found success with one of her goals — reconnecting with her children — but that’s just the tip of the iceberg for her.

“I would like to work with teenagers who’s in active addiction, that’s one of my main goals,” she said.

As for Tonya, she plans to be wherever her sons are living, even if it’s in another state.

“I want to be working and back with my kids,” she said. “I’d like to have a place where I can move my mom in with me and give her a break for a while because God knows I’ve wreaked havoc in her life for long enough.”